Journal of Emergencies, Trauma, and Shock
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ORIGINAL ARTICLE
Year : 2012  |  Volume : 5  |  Issue : 1  |  Page : 33-35

Evaluating conservative treatment for acute appendicitis with lump formation


1 Department of General Surgery and Allied Specialities, Sher-i-Kashmir Institute of Medical Sciences Srinagar, Jammu and Kashmir, India
2 Department of Radiology, Sher-i-Kashmir Institute of Medical Sciences Srinagar, Jammu and Kashmir, India

Correspondence Address:
Mohd Lateef Wani
Department of General Surgery and Allied Specialities, Sher-i-Kashmir Institute of Medical Sciences Srinagar, Jammu and Kashmir
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.93108

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Background: Interval appendectomy after acute appendicitis with lump formation (phlegmon) remains controversial. We conducted this study to determine the risk of recurrent appendicitis following initial non-operative treatment for appendicitis, and evaluate factors associated with recurrence. Secondarily, we evaluate the efficacy of interval appendectomy versus no appendectomy. Materials and Methods: Patients who received conservative treatment for appendicitis with lump formation were prospectively studied from June 2006 to June 2008. These patients were followed for recurrence of appendicitis. Results: Of 763 patients with acute appendicitis some 220 patients had lump formation (28.8%). Median age was 28 years. Conservative treatment was successful in 213 (96.8%) patients. The rate of recurrence was 13.1%, all occurring within six months after the index admission. Mean follow-up was 26±18 months. Conclusion: Conservative treatment of appendicitis with lump formation is efficient and the recurrence rate is low. Routine interval appendectomy after initial conservative treatment for lump formation is not a cost-effective intervention and not recommended.


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